Blood Disorders and Dental Health
Typically, blood disorders can affect overall oral health, as well as interfere with a number of dental procedures. Therefore, it is always important to let your dentist know if you have blood disorders, as well as information about medications used to treat these conditions.
Why Procedure is Used
While most people with blood disorders can see a regular dentist, some may need to go to a specialist. For example, if your platelet range is between 20,000 and 50,000, it will be to your advantage to see a dental specialist. Alternatively, if you have polycytemia vera, or excess red blood cell production, you may need to see a special type of dentist. Aside from helping reduce the risk of clots and bleeding, this type of dentist may also want to monitor your condition with bloodwork. As you may be aware, polycytemia can occur in heavy smokers, as well as individuals that have emphysema. Typically, this illness will cause red or purple regions on the tongue, as well as the lips, gums, and cheeks. Since polycytemia can occur when the body is lacking in oxygen, you may also develop this condition when you move to an area with a higher altitude.
Patient Concerns to be Addressed
If you have a low number of neutrophils (neutropenia) in your body, you may have an increased risk of getting bacterial infections. Typically, HIV/AIDS, as well as medications that interfere with the normal function of bone marrow can cause neutropenia. Unfortunately, if you have a mouth infection, the redness and swelling caused by the action of neutrophils may not be present. As may be expected, if you do not monitor your oral health carefully, you may find that gum diseases, thrush, deep mouth sores, and mouth ulcers can get out of control very quickly.
Aside from a lack of white blood cells, some people are also anaemic. As you may be aware, this condition may result from blood loss, destruction or reduced production of red blood cells, fluid overload, vitamin and nutrient deficiencies, genetic disorders, and issues with hemoglobin molecules. Aside from making the insides of your mouth look pale, your tongue may also be very smooth if you are anaemic. In addition, X-rays may reveal changes in your jawbone.
Individuals that are haemophiliacs, or have low platelet levels may have issues if they need to undergo procedures that result in bleeding. For example, a haemophiliac may need to take extra treatments to build up certain blood factors prior to dental treatments. In some cases, you may also not be able to tolerate certain kinds of anaesthesia. That said, you should be able to go for common dental procedures such as root canals, fillings, crowns, braces, and denture fittings. On the other hand, it is best to avoid oral surgery as much as possible.
Depending on the situation, you may also need to have dental procedures in a hospital setting. That said, today many people are able to inject blood factor products on their own. As may be expected, it will be best to discuss these issues with your doctor as well as your dentist. Chances are, your dentist will also want to see your latest bloodwork results in order to learn more about your platelet levels. You may also need to have additional bloodwork in order to determine if you need additional medication prior to certain dental procedures. In particular, if your platelet count goes below 20,000, you may need to have a platelet transfusion.
How Is Procedure Performed?
In some cases, people with blood disorders need antibiotics prior to having dental procedures. For example, if your neutrophil count is less than 1,000, or if you have aplastic anaemia, you will most likely need to use antibiotics, as well as use an antibiotic mouthwash. Depending on your blood counts, you may need to take these medications both before and after the procedure. On the other hand, i f you have some form of chronic anaemia, you may also need to have oxygen during certain procedures.
If you have disorders that would lead to uncontrolled bleeding, your dentist may also use antifibrinolytic medications. You may also need to take additional precautions based on the type of procedure, and the current condition of your blood. As may be expected, if you have sickle cell anaemia, it is best to have your teeth cleaned when the condition is in a dormant period.
Post-Operative Concerns
If you have thalassemia, or other types of chronic anaemia, healing may occur very slowly. Therefore, you should always carefully discuss any dental procedures with your dentist and find out how they will affect your blood counts. Even though your dentist will do everything possible to minimize bleeding, there are some things you will also need to be careful of after certain procedures.
Among other things, if you have braces, you will need to try and prevent cuts from the wires, brackets, and bands. In some cases, it may be better to have braces that attach to your teeth, as opposed to removable versions. For people that have haemophilia, it is also very important to replace blood factors that aid in clotting. Typically, you will need to have at least 50 - 100% of the normal level prior to surgery. As may be expected, you should replace these factors as needed after the procedure. It may also be of some help to eat soft foods, a well as take medication that reduce the chance of blood clots breaking. If you experience pain or discomfort, you will need to avoid aspirin, and other NSAID's (nonsteroidal anti-inflammatory drugs). This includes Advil, Ibuprofin, Motrin, and other similar painkillers.
Perils of Disease
In some cases, individuals with blood disorders such as haemophilia may be afraid to brush their teeth. While brushing can make your mouth bleed more than usual, you should try to observe proper oral hygiene as much as possible. It may also be of some help to ask your doctor for additional suggestions.
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